Health Evaluation Form

Bring your bird to the vet immediately if it is experiencing any of the following emergency conditions:

  • Your bird is sitting on the bottom of the cage fluffed up with its eyes closed, or
  • its tail is bobbing from labored breathing even though it isn’t being disturbed, or
  • if it is bleeding profusely or
  • has consumed a toxic substance, or
  • it is convulsing with seizures or if it has inhaled gas, teflon or smoke from a fire or burned food.

Health Evaluation Forms
The purpose of the following Health Evaluation Forms is to help bird owners track down the cause or causes of their bird’s ailment. This form is also used by members of the HolisticBird list who wish to ask other list members for help.

By answering the questions, the bird owner is guided through a troubleshooting process that often helps target the solution. Consider the questionnaire an aid to diagnosis, without which, appropriate help cannot be suggested.

The forms may be used for your own personal problem solving, for preparing for a vet visit, and to send to the HolisticBird list, if you are a member of the list, and would like to ask the other list members for help. To submit the form(s) to the list simply copy the relevant form(s) into your post and answer the questions.

Use the following to determine which forms you should fill out:

1. If your bird has a behavior problem such as screaming, biting or other aggression, fill out forms A through G.

2. If your bird is plucking or mutilating its feathers, fill out all of the forms.

3. If your bird has minor diarrhea or looks as if it isn’t feeling well because it is quieter than usual and isn’t eating as well, fill out forms A, C, D, E. F.

4. If your bird has been to the vet, fill out form B in addition to the other appropriate forms.

A. Introduction

Please briefly describe your bird’s health or behavior problem for which you are filling out this form.

Your name and email address

Bird’s name, species, and color mutation (if applicable)

Bird’s age and sex

Where was the bird obtained? (pet shop, breeder, rehome, rescue)

How long have you had this bird?

How long has the bird had this problem?

B. Veterinary Care

Has a vetinarian seen the bird?

What tests, cultures, X-rays, etc. were performed? Different vets consider different tests to be a ‘complete health screen’, so be specific about what lab work was done. (cbc, culture, gram stain, chemistries, x-rays, SPE)

What were the tests and the results?

What was the Veterinarian’s diagnosis?

Was treatment/medication prescribed?

Please detail what was given, dosages and duration of prescribed treatment.

Was there an improvement shown from treatment:

If treatment failed, what other steps were taken to resolve the problem:

Have you used herbs or remedies such as Echinacea, ACV, GSE, etc., how often and for what reasons:

Were any OTC (over the counter) treatments used prior to a vet visit:

Has this bird been diagnosed with PDD?

If so, was it before or after it was treated with baytril for a bacterial infection?

Was the diagnosis of PDD based on biopsy results or was it based on symptoms?

C. General Health

Normal droppings consist of three parts:

solid feces of different colors depending on what the bird is eating;
clear urine; and
white urates.
Droppings might be watery, slimy with mucus, well formed tubes, dry / hard, black /scant, contain whole seeds or other food, foamy, the urates or urine could also be colored.etc

Describe your bird’s droppings including solids, urates, and urine.

Have the droppings changed from normal frequency, color, consistency or quantity for this bird?

If so, describe

Has the bird’s eating habits and preferences changed?

Has the bird’s activity level, talking, singing changed?

Has the bird’s mood changed?

Is the bird cold and fluffed?

Is the bird breathing rapidly with tail bobbing when it is not being disturbed?

Is the bird perching or sitting at the bottom of the cage?

D. Diet and Nutrition

What is your daily feeding schedule?

How often do you feed?

When and what do you feed?

What percentage of the following foods does your bird actually eat? pellets, vegetables, fruit, seed mix, nuts, sprouts, meat and eggs, bird bread, table food, soak and cook, treats, junk food, other.

What kind of vegetables does your bird eat

What kind of fruit does your bird eat

Are the fruits and vegetables washed?

Are they organic?

What brands of pellets or seed mix does your bird eat

What kind of table foods and treats does your bird eat

How often do you allow junk food: chips, crackers, pasta, bread, candy ice-cream, cake, cookies.

Do you feed any supplements, and if so what kind?

Do you administer supplements on food or in water?

What foods does your bird refuse to eat?

What strategies have you used to improve the diet?

Does your bird crave any particular kind of food?

Have your bird’s food preferences changed lately?

E. Environment

Was anything in the home changed prior to the first display of symptoms? This could be a change of food, cage location, new bird additions, interior decoration (such as new drapes, carpet, furniture), new people, loss of bird buddy or human friend, etc.

How often is the cage cleaned?

How often is debris from the cage tray removed?

How often are the perches cleaned?

How often are food and water cups cleaned and disinfected?

How long is uneaten spoilable food left in the food dish?

How often are uneaten seeds and pellets removed and refreshed?

How often is water changed?

Are insects (house flies, fruit flies, ants, cockroaches etc) present on or in the bird’s food?

F. Social Interaction

Do you have other birds, and how do the birds react to each other?

Are there other pets in the household, and how does the bird respond to them

What other Human members of the family interact with the bird, and does the bird have preferences?

Are other pets or family members ill?

What is the cage location and how much activity is there in this location?

How does the bird respond to activity around the cage?

How does the bird respond to being alone?

How often and how long is the bird alone?

How often is the bird out of the cage to interact with family?

What type of exercise does the bird like, such as exploring, flying, showering etc?

Does the bird exhibit signs of sexual maturity?

G. Cage and Toys

Is the cage covered at night.

Does your bird sleep in a different cage:

What type of perches are in the cage and their positions:

What is used in the bottom of the cage (newspaper, corn cob, etc.) and can the bird reach it:

If toys are provided, what are the birds preferences:

Is the bird passive or aggressive to the toys, eg: plays with or destroys them

Are toys rotated or are the same ones left in the cage all the time:

H. Lighting

What type of lighting is used (such as incandescent or full spectrum):

Is the photo period (of lighting source) natural and regulated, or random and irregular:

Does the bird have access to natural sunlight or is taken outdoors Are night lights used:

I. Water

What is the water source and location, eg: bowl, dish, water bottle:

Does the bird like to bathe, and what is it’s favorite form of bath (mister, sink, bowl, etc) and how often:

Are supplements or anything else put in the water?

If so, what?

What is the drinking water source? (tap, well, municipal, filtered, bottle)

J. Household Safety

What are the major products you use for general housecleaning. eg: Clorox, Windex, types of soaps, floor products/waxes etc:

Are there carpets in the house and what chemicals are used for cleaning them:

What disinfectants are used to clean the birds cage: Are scented candles, strong perfumes, or Teflon pots and pans used:

What type of aerosol sprays are used, eg: room deodorizers, hair sprays, pesticides, etc:

Are there any smokers in the household, and do they handle the birds:

Are fabric softeners used in cage coverings: What type of ventilation (such as windows, vents, fans, etc.) is used when questionable products are used, or painting or heavy cleaning is done:

Does the bird sneeze or pluck after the vacuum has been used? Is the home heating electric, gas, oil, radiant or forced air:

What is the temperature in the house, and is it constant or varied:

What houseplants can the bird reach:

Are pest exterminators used:

Which method of pest control used:

K. Outdoors

If birds are housed outdoors what type of shelter is provided against sun and bad weather:

Do predators (cats, birds, mice, wild animals, insects) disturb/distress the bird during the night

Are fertilizers, herbicides, and pesticides used on trees or lawn

Do outside birds have access to treated lawns, trees or plants